Pelvic conditions such as urinary incontinence, fecal incontinence, and prolapse are a significant health concern worldwide. Men, women, and children of all ages can suffer from urinary incontinence or involuntary loss of urinary control. The lives of those who suffer urinary incontinence are perpetually interrupted by thoughts of ensuring ready access to a restroom. Everyday activities such as attending a theater or sporting event can become unpleasant. Sufferers often begin to avoid social situations in an effort to reduce the stress associated with their condition.
A variety of treatment options are currently available, but improvements are continually desired. Some current treatments include external devices, behavioral therapy (such as biofeedback, electrical stimulation, or Kegel exercises), prosthetic devices, and surgery. Depending on the age, medical condition, and personal preference of a patient, surgical procedures can be used to completely restore continence.
In the urology field, needles, suture passers and ligature carriers are used in a variety of procedures, many of which are designed to treat incontinence. A pubomedial sling procedure involves placement of a surgical implant in the form of a urethral sling to stabilize or support the bladder neck or urethra, to treat incontinence. Descriptions of various sling procedures are included at U.S. Pat. Nos. 5,112,344; 5,611,515; 5,842,478; 5,860,425; 5,899,909; 6,039,686; 6,042,534; 6,110,101; 6,478,727; 6,638,211; U.S. Publication Nos. 2010/0256442 and 2011/0034759; PCT Publication Nos. WO 02/39890; WO 2011/106419 and WO 02/069781.
Some pubomedial sling procedures extend a sling from the rectus fascia in the abdominal region to a position below the urethra and back again to the rectus fascia. Other procedures, used in particular to treat male stress urinary incontinence (SUI), can include introducing and deploying a mesh sling implant via multiple incisions. Namely, a first medial (e.g., perineal) incision can be made to expose the bulb of the urethra, which provides the first sling fixation point. Following that incision, two smaller incisions can be made in the creases where the patient's thighs join the pelvis to allow introducer needles to pass through the skin into the perineal incision. The sling can then be connected to the needles and pulled into position, with the ends of the sling drawn outside of the body to allow for tensioning before being trimmed at skin level.
While many of the above-identified methods and systems currently provide efficacious options for treating pelvic conditions including but not limited to prolapse and urinary incontinence in male and female patients, improved methods, devices, tools, and systems are continuously pursued.